Inner Representations,Coping, and Posttraumatic Stress Symptomatology in a Community Sample of Trauma Survivors

To assess whether coping styles mediated the relation between inner representations and posttraumatic stress symptomatology, a community sample of self-defined trauma survivors (N = 95) completed the World Assumptions Scale, Ways of Coping Checklist—Revised, and Trauma Symptom Inventory. Regression analyses indicted that individuals with more positive inner representations reported experiencing less symptomatology and tended to use more active and less passive coping strategies. Furthermore, the relation between inner representations and the extent of symptomatology was mediated through the use of passive coping strategies, although the latter 2 variables were likely reciprocally related. The implications of these findings for the well-being of trauma survivors were discussed.     

应对方式、社会支持和心理压力对中学生心理健康的影响研究

该研究采用中学生应激源量表、中学生应对方式量表、领悟社会支持量表和症状自评量表(SCL-90)对852名初一至高三的学生进行了调查。通过单因变量多维交互效应的方差分析,结果表明：消极应对方式对中学生的心理健康影响较大;积极应对方式与心理健康的相关不显著;社会支持对心理健康的影响同时具有主效应和缓冲效应;心理压力与心理健康之间存在着显著相关;应对方式和社会支持在心理压力与心理健康的关系中彼此独立起作用,两者之间的交互作用不明显。     

Development of the HIV/AIDS Stress Scale

Development of a self-report measure of stress specific to HIV/AIDS is needed to advance our understanding of the role of stress in adaptation to HIV/AIDS; hence, the aim of this study was the development of the HIV/AIDS Stress Scale. A total of 132 homosexual/bisexual men with HIV/AIDS were interviewed and completed the HIV/AIDS Stress Scale and measures of coping strategies, appraisal, social support and adjustment (global distress, depression, social adjustment, number of HIV symptoms, and subjective health status) at three time points. Thirty-nine primary caregivers were interviewed and completed measures of stress and adjustment. Exploratory factor analyses of the HIV/AIDS Stress Scale items revealed three factors: Social, Instrumental and Emotional/Existential Stress. Factors had adequate internal reliabilities and were stable over 12 months. Construct validation data are consistent with recent stress/coping research that links higher levels of stress with more HIV symptoms, reliance on emotion-focused coping, lower social support, poorer levels of adjustment and higher levels of caregiver stress. Results extend this research by revealing new differential relations between various stress dimensions and stress/coping variables. Convergent validation data suggest that the HIV/AIDS Stress Scale shares conceptual similarity with threat appraisal, and differs from controllability and challenge appraisals. The HIV/AIDS Stress Scale shows potential for the elucidation of the role of stress in coping and adaptation to HIV/AIDS and disease progression in both research and clinical applications.     

Social Relations,Coping, and Psychological Distress Among Persons With HIV/AIDS1

The interrelationships among social support, coping style, and psychological distress were examined using longitudinal data from a sample of 212 persons with HIV/AIDS. Structural equation modeling analyses showed significant indirect effects on psychological distress for avoidant coping, feeling loved and understood, satisfaction with support, rejection by family members, discrimination because of HIV status, and number of AIDS symptoms. The inclusion of negative social interactions in the model is an important extension of the stress‐support literature. Feeling loved and understood mediated the relationship between social support and coping style choice. Results highlight the multidimensional nature of the processes that shape psychological outcomes in HIV disease. and suggest several potential points of intervention, including social‐support efforts that increase the sense that one matters to others, and interventions to assist patients to move from avoidant to active coping strategies.     

Vicarious traumatisation in telephone counsellors: internal and external influences

The present study investigated vicarious traumatisation among telephone counsellors. In particular, the influence of coping style, supervision, and personal trauma history on vicarious traumatisation was examined. A total of 62 telephone counsellors from trauma related fields completed a series of self-report measures. Generally, levels of traumatisation (i.e. PTSD symptoms and disruptions in beliefs) were low. Nonetheless, five (8.2%) participants had total scores indicating 'high average' to 'very high' levels of disruption in beliefs. Also, 15 (25.9%) respondents reported that they experienced at least one PTSD symptom. As expected, non-productive coping was related to disruptions in cognitive beliefs, while dealing with the problem was not. In addition, having a strong supervisory working alliance was associated with lower levels of disruption in beliefs. Contrary to expectations, there were no significant predictors of PTSD symptoms despite a positive correlation with personal trauma history. In conclusion, vicarious traumatisation is of concern for telephone counsellors. Efforts to address its impact should focus on developing effective coping styles and enhancing the quality of supervision.     

Emotional distress in nonmetropolitan persons living with HIV disease enrolled in a telephone-delivered, coping improvement group intervention.

The study delineated depressive symptoms and modeled emotional distress in persons living with HIV disease in nonmetropolitan areas of 13 U.S. states. Participants (N=329) were enrolled in a randomized clinical trial of a telephone-delivered, coping improvement group intervention, and 60% reported moderate or severe levels of depressive symptomatology on the Beck Depression Inventory. Structural equation modeling indicated that participants who experienced more severe HIV symptomatology, received less social support, and engaged in more avoidant coping also experienced more emotional distress (a latent construct comprising depressive symptoms and emotional well-being). Greater HIV-related stigma and rejection by family led to more emotional distress, with social support and avoidant coping mediating almost entirely the effects of the former 2 variables. The model accounted for 72% of the variance in emotional distress in nonmetropolitan persons living with HIV disease.     

Examination of the Salutogenic Model,Support Resources,Coping Style,and Stressors Among Israeli University Students

The author investigated A. Antonovsky's (1979) concept of the sense of coherence (SOC) in relation to social support, coping styles, and the stress experiences of college students. A multivariate model was used to assess the relationships between the psychosocial resources, perceived stress, and the effect of different coping styles among 261 undergraduate students in three Israeli institutions of higher education. Results of a multivariate analysis of variance revealed that younger students used more emotional strategies and perceived having greater social support from friends than did older students. Students who did not work reported experiencing higher levels of stress associated with daily life and work-related issues. Women used more emotional and avoidance coping strategies. The findings of the regression analysis demonstrated that task-oriented and emotional coping modes, work stress, and family support explained 30% of the variance of SOC. These results increase our understanding of the salutogenic model of students within university settings and suggest focusing on the students and their interaction with the environment, using the concepts of stress, coping, and social support as inseparable characteristics of systems models.     

Examination of the salutogenic model, support resources, coping style, and stressors among Israeli university students

The author investigated A. Antonovsky's (1979) concept of the sense of coherence (SOC) in relation to social support, coping styles, and the stress experiences of college students. A multivariate model was used to assess the relationships between the psychosocial resources, perceived stress, and the effect of different coping styles among 261 undergraduate students in three Israeli institutions of higher education. Results of a multivariate analysis of variance revealed that younger students used more emotional strategies and perceived having greater social support from friends than did older students. Students who did not work reported experiencing higher levels of stress associated with daily life and work-related issues. Women used more emotional and avoidance coping strategies. The findings of the regression analysis demonstrated that task-oriented and emotional coping modes, work stress, and family support explained 30% of the variance of SOC. These results increase our understanding of the salutogenic model of students within university settings and suggest focusing on the students and their interaction with the environment, using the concepts of stress, coping, and social support as inseparable characteristics of systems models.     

Perfectionism, Coping, Social Support, and Depression in Maltreated Adolescents

The current study examined the associations among dimensions of perfectionism, coping, social support, and depression in 58 adolescents with a history of maltreatment. Participants completed the Child-Adolescent Perfectionism, multidimensional measures of coping and social support, and the CES-D Depression Scale. Correlational analyses showed that depression was associated with socially prescribed perfectionism, internalized emotion-oriented coping, avoidant-oriented distancing, and low family support and peer support. Analyses of coping responses and perfectionism established links between self-oriented perfectionism and internalized emotion-oriented coping responses and self-reliant problem-solving. Socially prescribed perfectionism was associated with avoidance-oriented coping (i.e., distancing). While self-oriented perfectionism and social support were unrelated, socially prescribed perfectionism was associated with reduced levels of family support. Collectively, the findings highlight the roles of poor coping and social support as contributors to the emotional distress experienced by maltreated adolescents. Moreover, it is suggested that the distress experienced by perfectionistic youth with a history of maltreatment reflects, in part, the role of maladaptive coping styles and coping resource deficits. Our findings support further consideration of personality dimensions such as perfectionism as contributors to poor functioning among maltreated youth.     

Coping strategies from the perspective of two developmental markers: age and social reasoning

In this study, we examined coping from a developmental perspective, including its relation to age and social cognitive maturity. The 60 participants, who ranged from adolescents to mature adults, were given Lazarus' Ways of Coping Scale. This consists of both an emotion-focused and problem-focused coping score and two measures of social reasoning performance. Social reasoning was the best predictor of emotion-focused coping, above and beyond years of education and age. None of the developmental variables predicted problem-focused coping. Analyses examining the effect of perceived controllability of the stressful situation on coping demonstrated that it differentially mediated choice of coping strategy across age groups. Whereas older participants endorsed more problem-focused strategies in perceived controllable situations and emotion-focused strategies in perceived uncontrollable situations, adolescents endorsed emotion-focused and defensive coping styles, irrespective of perceived controllability. Implications for the study of development of coping styles in affectively salient contexts is discussed.     

Relationships among optimism, coping styles, psychopathology, and counseling outcome

This study had two objectives. The first objective was to evaluate the discriminant validity of optimism by examining the relationships between optimism and coping styles, while controlling for psychopathology. The second objective was to evaluate how well optimism, coping styles, and psychopathology predicted counseling outcome. Participants consisted of 96 college students involved in individual counseling at a university counseling center located in the southeastern United States. Consistent with previous studies, optimism was positively correlated with task-oriented coping and social diversion (social support), and it was negatively correlated with emotion-oriented coping and avoidance (distraction) coping. However, after partially out psychopathology, only the relationship between optimism and task-oriented coping remained statistically different from zero. Both optimism and psychopathology predicted two measures of counseling outcome. In contrast, coping styles were not useful for predicting any of the outcome measures. Results provide limited support for the discriminant validity of optimism in general and the Life Orientation Test in particular.     

Ethnic and Gender Differences in Distress Among Anglo American, African American, Japanese American, and Mexican American Spousal Caregivers of Persons with Dementia

Distress, coping, and social resources were compared in a sample of 202 Japanese-, Anglo-, African-, and Mexican American spousal caregivers of persons with dementia using a Stress-Coping model. Both ethnicity and gender showed differential effects on the outcome and on the moderating variables. Female caregivers in all ethnic groups reported significantly higher levels of psychiatric symptomatology. All 4 ethnic groups reported high rates of psychological distress, with Mexican Americans reporting significantly higher rates of depression than Anglo or African Americans. Ethnicity was related to (1) the kind of caregiving appraisals (spiritual, pessimistic, and lack of support), (2) coping styles (escape-avoidance and seeking social support), and (3) social support. African Americans were more likely to be spiritual appraisers, to have more positive appraisals, and to have more social support available to them. Gender differences were evident on 4 out of the 6 caregiver appraisals, but none of the coping styles. Although males tended to have more perfectionistic appraisals, they were also more likely to view caregiving with a less negative and more self-efficacious outlook.     

污名应对策略的研究现状与展望

应激与应对的理论发展构建了污名应对研究的基本框架。污名应对策略是指被污名者在具体污名情境中为减少压力的消极影响而有目的地采用的情绪、认知和行为反应。目前, 关于被污名者应对污名策略的研究, 特别是艾滋病污名应对策略的研究日趋增多。根据不同的划分标准, 可以区分出问题聚焦性与情绪聚焦性策略、卷入与摆脱策略以及前摄性与反应性策略; 对于可隐藏污名而言, 还涉及到表露/隐藏策略。在研究方法上, 质性研究范式日益发挥重要作用。未来应该注重污名应对策略的情境性, 加强不同污名领域的专题研究, 关注对应对策略的评价并构建污名应对策略的层次模型。     

The Relationship between Socio-demographic Characteristics, Family Environment, and Caregiver Coping in Families of Children with Cancer

The factors that influence caregiver coping mechanism preferences after a child’s diagnosis with cancer are not fully understood. This study examines the relationship between caregivers’ socio-demographic characteristics and the coping strategies they use to adapt to childhood cancer. Sixty caregivers of pediatric cancer patients completed a socio-demographic questionnaire, the Family Environment Scale, and the COPE inventory. There were no significant differences in family environment by income or education. Caregiver educational attainment was positively associated with use of planning and active coping styles, while income was not associated with caregiver coping style. Mothers were more likely than fathers to use active coping, instrumental support, religious coping, and emotional support. Men with lower education engaged in greater substance use coping and lower planning. The findings show that educational attainment and caregiver gender influence caregiver coping styles following a pediatric cancer diagnosis and suggest that educational attainment rather than financial resources drive the association between SES and coping. Programs that address educational gaps and teach caregivers planning and active coping skills may be beneficial for parents with lower educational attainment, particularly men.     

Coping Strategies as Predictors of Distress in Survivors of Single and Multiple Sexual Victimization and Nonvictimized Controls

This study investigated the relationship between coping strategies and distress symptomatology in survivors of sexual revictimization. Coping strategies were assessed with the revised Ways of Coping Scale (Aldwin & Revenson, 1987). Distress symptoms included global distress, depression, anxiety, and somatization. Subjects were 44 survivors of sexual victimization in both childhood and adulthood; 54 survivors of a single incident of sexual victimization in childhood; and 256 nonvictimized individuals. All were drawn from a subject pool of female undergraduate students. Multivariate analysis of variance revealed significant differences between groups on reported symptomatology and coping strategies. Victimized groups reported more distress than did the nonvictimized group. The multiple victimization group indicated greater use of coping strategies than did the nonvictimized group, and both victimized groups reported greater use of the escapism strategy than did the nonvictimized group. Multiple backward regression analysis found that coping strategies were predictive of distress symptomatology in all three groups, with escapism as the most potent predictor of distress for each group. Coping strategies were the most powerful predictors of distress in the multiply victimized group. The results of this study provide strong support for the importance of addressing coping strategies in clinical intervention of distress, particularly with survivors of multiple sexual victimization.     

Defense mechanisms and coping strategies in conjugal relationships: An integration

Coping strategies and defence mechanisms are used to describe people's responses to stressful situations. The concept of coping strategies comes from the social psychological tradition, whereas the concept of defence mechanisms comes from the psychoanalytic tradition. According to the traditional view, the two concepts are very different. However, recently, a growing number of researchers suggested that coping strategies and defence mechanisms are more interrelated than what was assumed previously. This study was aimed at documenting the relationship between both concepts in the context of predicting adjustment in a specific situation, marital relationships, one of the most well‐suited situations to investigate people's responses to stressful situations. The sample consisted of 157 couples. Each partner completed the Ways of Coping Questionnaire, the Defense Style Questionnaire, and the Dyadic Adjustment Scale. Two theoretical models, the independence model and the effectiveness model, accounting for the relationship between coping strategies and defence mechanisms were first tested, using confirmatory factor analyses. According to the independence hypothesis, one latent dimension should measure defence mechanisms and the other latent dimension should measure coping strategies. According to the effectiveness hypothesis, coping strategies and defence mechanisms could vary along two dimensions: adaptive and maladaptive ways of dealing with marital difficulties. Results revealed that the effectiveness hypothesis was a better representation of the relationship between the two concepts than the independence hypothesis. The unique contribution of defence mechanisms and coping strategies to the prediction of marital adjustment was next examined using multiple regression analyses. Again, results were generally congruent with the effectiveness hypothesis. Positive and negative relationships with marital adjustment were observed for both concepts. In addition, coping strategies did not result in more positive outcomes on marital adjustment than defence mechanisms. It seems that coping strategies and defence mechanisms have both their specificity and their shared characteristics.     

Reviewers for Special Issue

Objective: An enhanced stress and coping model was used to explain depression among HIV‐positive women in healthcare and community settings where highly active anti‐retroviral treatment (HAART) was commonplace. Method: HIV‐infected women in four cities (N=978) were assessed, cross‐sectionally, for mental and physical health, stress, social support, and other background factors. Results: Self‐reported level of depressive symptomatology was high. Number of physical symptoms, illness intrusiveness, and perceived stress were positively associated with depressed mood, while coping self‐efficacy and social support were negatively associated. Stress mediated the effect of health status on depression and coping self‐efficacy mediated the effect of psychosocial resources on depression. Our enhanced stress and coping model accounted for 52% of variance in depressive symtpomatology. Conclusions: Interventions focused on improving coping self‐efficacy, bolstering social supports, and decreasing stress in the lives of HIV‐positive women may help to reduce the negative effects of HIV disease on mood.     

Presurgical Coping, Depression, and Quality of Life in Persons with Parkinson's Disease

This study describes utilization of coping strategies and evaluates the interaction between coping strategies, depression, and quality of life (QOL) in patients with Parkinson's disease (PD) who are being considered for neurosurgical intervention. Eighty patients (mean age 61.7 years) with PD being evaluated for possible deep brain stimulation completed self-report instruments of coping strategies (Coping Responses Inventory), depression (Beck Depression Inventory), and disease-specific QOL (Parkinson's Disease Questionnaire-39). Analyses showed that patients with PD cope with the acute stressor of approaching neurosurgery through a variety of strategies, but particularly avoidant and behavioral strategies. When the correlated but apparently opposing effects of cognitive and behavioral strategies were teased apart, greater use of cognitive strategies was associated with more severe depressive symptomatology (and poorer QOL), while greater use of behavioral strategies appeared to be associated with less depression. Depressive symptomatology, in turn, was associated with poorer QOL. However, coping had minimal direct association with QOL. From this it was concluded that patients with advanced PD generate a variety of coping responses to an acute stressor such as surgery, and the use of behavioral strategies, in particular seeking of alternative enjoyable activities, may be associated with better mood if salutary effects are not overwhelmed by less helpful cognitive coping techniques. The minimization of depressive symptomatology, in turn, is associated with better QOL.     

Cross-sectional and Longitudinal associations in coping strategies and physical health outcomes among HIV-Positive youth

This study assessed whether coping styles had an influence on physical health outcomes either concurrently or longitudinally in a sample of HIV-positive youth. Coping styles were characterized as positive, passive, depressive withdrawal, and escapist. A cross-sectional latent variable analysis (N = 279) assessed associations among environmental stress, self-esteem, social support, coping styles, AIDS symptoms, and CD4 count. A more restricted longitudinal analysis (N = 174) tested associations among earlier environmental stress, self-esteem, coping styles, and AIDS symptoms at follow-up. CD4 count was not associated with coping styles in the cross-sectional analysis. Concurrent AIDS symptoms were significantly predicted by depressive withdrawal and environmental stress. A passive coping style modestly predicted more AIDS symptoms longitudinally. Correlates of perceived health and well-being of persons with HIV/AIDS are important to investigate in addition to more objective measures such as CD4 count that may not be amenable to change through coping style interventions alone.     

Community violence victimization and aggressive behavior: the moderating effects of coping and social support

Exposure to community violence (CV) as a victim is an established risk factor for exhibiting later aggressive behavior. It is unclear, however, what factors may mitigate this relationship. This study tested the relationship of CV victimization to aggressive behavior, and the roles of coping style and perceived social support in moderating that relationship. Five hundred and fifteen 18–22‐year‐old men and women completed self‐report inventories on CV exposure, aggressive behavior, perceived support from family and friends, and coping strategies. From a prior study, factor analysis of the coping scales yielded three factors of (1) disengagement (i.e., using primarily avoidant strategies), (2) interpersonal (i.e., using primarily emotion‐focused strategies) and (3) problem‐focused (i.e., using primarily active/approach strategies) coping styles. Results indicated that high CV victimization, high disengagement (i.e., avoidant) and interpersonal (i.e., emotion‐focused) coping styles, and low perceived support from friends significantly predicted increased aggression scores. Significant moderating effects indicated that, as CV victimization increased in frequency, aggression scores were highest for those with low perceived friend support and high use of disengagement coping. Findings suggest that avoidant and emotion‐focused coping styles are risk factors, and perceived support from friends is a protective factor, for a putative “cycle of violence.” Aggr. Behav. 32:502–515. 2006. © 2006 Wiley‐Liss, Inc.